| NPI | 1770135048 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: AZ D010433) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: TX 37015) |
| Enumeration Date | 2019-07-16 |
| Last Update Date | 2021-02-10 |